scholarly journals Minimally invasive saphenous vein harvesting using the mayo vein harvester. An alternative to endoscopic vein harvesting?

2020 ◽  
Author(s):  
Jeremy Chan ◽  
Harry Smith ◽  
Tracey Cox
Keyword(s):  
Minimally Invasive ◽  
Saphenous Vein ◽  
Artery Bypass ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Endoscopic Vein Harvesting ◽  
The Cost ◽  
Invasive Techniques ◽  
And Training ◽  
Vein Harvesting

The Great saphenous vein (GSV) has been widely used as a conduit for Coronary artery bypass grafting. The GSV can be harvested using the open or minimally invasive technique. Minimally invasive techniques are growing in popularity due to better cosmetic and wound infection outcomes. The most widely used method in minimally invasive technique is via endoscopic approach. However, the cost of endoscopes and training curve can limit its use. We describe an alternative minimally invasive technique using a mayo vein harvester with a considerably lower cost, and a smoother learning curve. Keywords: Saphenous vein harvesting, Mayo vein harvester, Minimally invasive

scholarly journals A randomised controlled techniques saphenous vein harvest; morbidity lowering with minimally invasive technique

2018 ◽  
Vol 5 (8) ◽  
pp. 2727
Author(s):  
Sudheendra Tekalkote ◽  
Sartaj B. Hussein
Keyword(s):  
Minimally Invasive ◽  
Saphenous Vein ◽  
Minimally Invasive Technique ◽  
Controlled Study ◽  
Invasive Technique ◽  
Organ Bath ◽  
Open Technique ◽  
Long Saphenous Vein ◽  
Group A ◽  
Vein Harvesting

Background: The long incision is associated with significant intra-operative and postoperative complications. The use of minimal invasive saphenous vein harvesting has been advocated in an effort to minimize such wound related problems. The objective of this study was to compare the morbidity associated with long saphenous vein harvesting using the traditional open technique (A) against a minimally invasive technique using the Mayo vein stripper (B) that involves multiple short incisions.Methods: Authors conducted a prospective randomized controlled study in 80 patients undergoing first time coronary artery bypass grafting. Pain and healing was assessed on each postoperative day. Rings of long saphenous vein were subjected to organ-bath evaluation of endothelium-dependent and endothelium-independent relaxation. Three patients were excluded from the study, leaving 38 patients in Group A and 39 in Group B.Results: With respect to operative procedure, Group A had a greater length of vein harvested than Group B. There was no statistical difference in pain scores and endothelium-dependent or endothelium-independent relaxation between the two groups. However, there were significantly more infections in Group A compared with Group B.Conclusions: Harvesting vein through multiple incisions using the Mayo vein stripper is quicker, results in fewer infections and has no deleterious effect on endothelial function compared to open technique.

Abstract P158: Long-Term Outcomes of Endoscopic Vein Harvesting After Coronary Artery Bypass Grafting

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Lawrence Dacey ◽  
John Braxton ◽  
Robert Kramer ◽  
Joseph Schmoker ◽  
David Charlesworth ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Saphenous Vein ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Endoscopic Vein Harvesting ◽  
Repeat Revascularization ◽  
Risk Of Mortality ◽  
Vein Harvesting

Introduction: Endoscopic saphenous vein harvesting has developed into a standard of care at many cardiothoracic surgical centers. The association between this technique and long-term morbidity and mortality has recently been called into question. We describe the association between use of open versus endoscopic vein harvesting and the risk of mortality and repeat revascularization within northern New England during a time period (2001-2004) in which both techniques were being performed. Methods: Prospective cohort study. From 2001-2004, 52.5% (4,485 of 8,542) of patients undergoing isolated coronary artery bypass grafting surgery had their saphenous vein harvested endoscopically. Surgical discretion dictated the vein harvest approach. Results: Use of endoscopic vein harvesting increased from 34% (781 of 2,291) in 2001 to 75% (1,341 of 1,792) in 2004. Patients undergoing endoscopic vein harvesting had greater disease burden. Endoscopic vein harvesting was associated with a significant reduction in long-term mortality [adjHR: 0.79, (CI 95% 0.68, 0.91)] and risk of repeat revascularization or mortality [adjHR: 0.87, (CI 95% 0.78, 0.98), Figure]. Endoscopic vein harvesting was associated with a non-significant increased risk of repeat revascularization [adjHR: 1.08, (CI 95% 0.89, 1.31)]. Similar results were obtained in a propensity-matched analysis. Conclusion: The use of endoscopic vein harvesting was associated with a reduced risk of mortality as well as a composite endpoint of mortality or repeat revascularization four years after the index admission. This practice insignificantly increased the risk of repeat revascularization.

scholarly journals A Prospective Audit of Endoscopic Vein Harvesting for Coronary Artery Bypass Surgery

2009 ◽  
Vol 91 (5) ◽  
pp. 426-429 ◽  
Author(s):  
Zakariya Waqar-Uddin ◽  
Manoj Purohit ◽  
Nadene Blakeman ◽  
Joseph Zacharias
Keyword(s):  
Patient Satisfaction ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Saphenous Vein ◽  
Coronary Artery Bypass Surgery ◽  
Artery Bypass ◽  
Prospective Audit ◽  
Endoscopic Vein Harvesting ◽  
Long Saphenous Vein ◽  
Vein Harvesting

INTRODUCTION The objectives of this study were to: (i) assess the feasibility of minimally invasive endoscopic harvesting of the long saphenous vein or radial artery for use as conduit during coronary artery bypass surgery in the NHS setting; and (ii) investigate the results of endoscopic vein harvesting with regards to postoperative complications, ability to mobilise, and patient satisfaction. PATIENTS AND METHODS In this prospective audit, 25 consecutive patients, aged 52–90 years, undergoing either coronary artery bypass grafting alone or together with valve surgery or atrial fibrillation ablation were studied. All data were entered in purpose-designed proforma. Pre-operative risk factors including increasing age, diabetes, peripheral vascular disease, obesity, renal impairment, tobacco consumption and steroid use were documented. Time taken for harvest and conversion to traditional open vein harvest, quality of harvested vein in terms of number of repairs and vein damage were recorded. Postoperatively, we recorded harvest site wound complications, number of days to mobilise and total hospital stay. Pain score and patient satisfaction were also assessed. RESULTS There was one death due to myocardial infarction; another patient had postoperative cerebrovascular accident. A total of 43 lengths of grafts were harvested, 41 were long saphenous vein and two radial artery. Vein harvest time reduced significantly from a maximum of 94 min to 34 min for two lengths of long saphenous vein. Three patients required conversion from endoscopic vein harvesting to open vein harvest. The only postoperative complication directly related to endoscopic harvesting was bruising along the tunnel created by the passage of the instruments. None of the patients had any wound complication; none required antibiotics or wound debridement. Mean time to mobilise was 3.4 days. All patients who underwent successful endoscopic vein harvesting expressed satisfaction with regards to postoperative pain and cosmetic result. CONCLUSIONS Competence and ability to harvest conduit in an acceptable time frame are obtainable after a relatively low number of cases. The procedure is associated with a low number of postoperative complications and very high patient satisfaction.

Minimally invasive technique for ligation and stripping of the small saphenous vein guided by intra-operative duplex ultrasound

The Surgeon ◽  
2006 ◽  
Vol 4 (6) ◽  
pp. 372-377 ◽  
Author(s):  
M.S. Whiteley ◽  
G. Lewis ◽  
J.M. Holdstock ◽  
C. Smith ◽  
C.S. Harrison ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Saphenous Vein ◽  
Duplex Ultrasound ◽  
Minimally Invasive Technique ◽  
Invasive Technique

scholarly journals Predictive value of great saphenous vein mapping prior to endoscopic harvesting in coronary artery bypass surgery

2020 ◽  
Vol 31 (1) ◽  
pp. 16-19
Author(s):  
Ferdi Akca ◽  
Ka Yan Lam ◽  
Niels Verberkmoes ◽  
Ignace de Lathauwer ◽  
Mohamed Soliman-Hamad ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Saphenous Vein ◽  
Predictive Value ◽  
Great Saphenous Vein ◽  
Artery Bypass ◽  
Endoscopic Vein Harvesting ◽  
Preoperative Mapping ◽  
Coronary Bypass Grafts ◽  
Vein Harvesting

Abstract OBJECTIVES The use of endoscopic vein harvesting in patients undergoing coronary artery bypass grafting is increasing, often using bedside mapping. However, data on the predictive value of great saphenous vein (GSV) mapping are scarce. This study assessed whether preoperative mapping could predict final conduit diameter. METHODS A prospective registry was created that included 251 patients. Saphenous vein mapping was performed prior to endoscopic vein harvesting at 3 predetermined sites. After harvesting and preparing the GSV, the outer diameters were measured. Appropriate graft size was defined as an outer diameter between 3 and 6 mm. RESULTS A total of 753 GSV segments were analysed. The average mapping diameter was 3.2 ± 0.7 mm. The harvested GSV had a mean diameter of 4.7 ± 0.8 mm. Mapping diameters were significantly positively correlated with actual GSV diameters (correlation coefficient, 0.47; P < 0.001). If the preoperative mapping diameters were between 1.5 and 5 mm, 96.6% of the GSVs had suitable dimensions after endoscopic vein harvesting. CONCLUSIONS Preoperative bedside mapping moderately predicts final GSV size after endoscopic harvesting but could not detect unsuitable vein segments. However, the majority of endoscopically harvested GSVs had diameters suitable to be used as coronary bypass grafts.

scholarly journals Is there an optimal minimally invasive technique for left anterior descending coronary artery bypass?

2011 ◽  
Vol 6 (1) ◽  
Author(s):  
Olivier Jegaden ◽  
Fabrice Wautot ◽  
Thomas Sassard ◽  
Isabella Szymanik ◽  
Abdel Shafy ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Minimally Invasive ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Minimally Invasive Technique ◽  
Invasive Technique

scholarly journals Remote patency of aortocoronary bypass grafts after endoscopic and conventional great saphenous vein harvesting

2016 ◽  
Vol 97 (4) ◽  
pp. 486-492
Author(s):  
A G Varlamov ◽  
R K Dzhordzhikiya ◽  
A R Sadykov
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Aortocoronary Bypass ◽  
Bypass Grafts ◽  
Cardiac Events ◽  
Endoscopic Vein Harvesting ◽  
Group Frequency ◽  
Vein Harvesting

Aim. To compare patency of aortocoronary bypass grafts in remote period after endoscopic and conventional (open) great saphenous vein harvesting. To analyze the patency of aortocoronary bypass grafts after endoscopic vein harvesting from calf and thigh.Methods. The study involved 170 patients who underwent elective isolated coronary artery bypass grafting. Treatment results were evaluated in two prospectively formed groups: endoscopic (85 patients) and open (85 people) vein harvesting. Endoscopic vein harvesting was performed both from the calf and from the thigh through popliteal access using endoscopic system Vasoview 6.0. Patency of autovenous aortocoronary grafts was studied in 2.6±1.17 years after surgery using 64-slice contrast-enhanced MDCT or traditional angiography. Angiographic follow-up covered 76 patients with endoscopic vein harvesting and 79 patients with open vein harvesting.Results. The studied groups did not differ in the frequency of detection of occluded, stenotic and fully patent autovenous aortocoronary bypass grafts (p=0.841). In endoscopic vein harvesting group frequency of autovenous aortocoronary bypass grafts occlusion was 25.7%, in the group of open vein harvesting - 25.1% (p=0.984). There was no difference in the patency of internal thoracic artery grafts to the left anterior descending artery (p=0.227), and freedom from adverse cardiac events (p=0.342). Occlusion of autovenous grafts after endoscopic harvesting from the calf developed less frequently than after endoscopic harvesting from the thigh (15.1 vs. 34.6%; p=0.013). Grafts after endoscopic harvesting in the knee region occluded most often (41.9%). Patency of aortocoronary bypass grafts after open vein harvesting was not dependent on the area of the vein harvesting (p=0.900).Conclusion. Endoscopic vein harvesting does not compromise the patency of aortocoronary bypass graft and does not increase the risk of its occlusion; endoscopic harvesting of the veins from the calf improves indicators of aortocoronary grafts patency and reduces the risk of graft failure (odds ratio 0.3; 95% confidence interval 0.14-0.8; p = 0.013).

scholarly journals Experience of using scleroobliteration in venous angiodysplasia (results of 12-month follow-up)

2021 ◽  
Vol 29 (3) ◽  
pp. 410-418
Author(s):  
Sergey V. Sapelkin ◽  
Natal'ya A. Druzhinina ◽  
Alexander F. Kharazov ◽  
Andrey V. Chupin
Keyword(s):  
Minimally Invasive ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Laser Coagulation ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Local Spread ◽  
Initial Symptoms ◽  
Radiofrequency Obliteration ◽  
Invasive Techniques

AIM: To evaluate the results of using the minimally-invasive technique of scleroobliteration in patients with venous malformations. MATERIALS AND METHODS: From 2006 to 2020, 41 interventions were performed for venous-cavernous angiomatosis of various localization through scleroobliteration. Nineteen patients (46.3%) underwent complex treatment, which included a combination of this minimally-invasive technique with other surgical interventions (resection of angiomatous tissues, laser coagulation, and radiofrequency obliteration). RESULTS: Clinical improvement was achieved in 38 (92.7%) patients. According to the data of ultrasound control, 25 patients (61%) experienced no blood flow in the obliteration zone, and there was regression of the initial symptoms within 1 year of observation following intervention. The results of treatment were better due to the local spread of the angiomatous process. With diffuse forms, it was not possible to achieve a positive effect in 3 patients (11.1%). CONCLUSION: Scleroobliteration can provide a positive result in the treatment of patients with venous-cavernous angiodysplasia, both as an independent method and in combination with other minimally-invasive techniques.

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